Field Reimbursement Manager

Field Reimbursement Manager (FRM)

– Key Responsibilities

• Serve as a compliant SME for reimbursement, access, and specialty distribution in assigned geography.
• Educate HCP offices on coverage status, prior authorization, appeals, and alternate funding for uninsured/underinsured patients.
• Build relationships with HCPs, office staff, and health system stakeholders.
• Analyze regional/local payer coverage trends, reimbursement criteria, and payer mix.
• Advise on specialty pharmacy services and complex distribution navigation.
• Partner with Patient Support on benefit investigations and patient onboarding.
• Collaborate with internal teams to develop local access strategies.
• Develop and execute territory-level business plans using customer insights.
• Resolve reimbursement issues in the field and elevate cases as needed.
• Identify process improvements to improve patient access and provider satisfaction.
• Maintain compliance with legal/regulatory/company policies (including privacy and promotional conduct).

• Bachelor’s degree in an allied health field (preferred) or equivalent experience.
• 8+ years in pharmaceutical/biotech/related healthcare.
• Required reimbursement experience: prior authorizations and navigating the US payer landscape.
• 3–6 years supporting Specialty Pharmaceuticals/Biologics.
• Deep knowledge of reimbursement/access/specialty pharmacy operations; specialty distribution models and patient services programs.
• Experience supporting product launches and/or insurance approval processes.
• Knowledge of HIPAA and other federal/state confidentiality and healthcare communications laws.
• Bilingual (English/Spanish) highly desired.
• Proven track record with complex therapies in rare/specialty conditions.
• Exceptional communication/interpersonal skills; build trust; manage multiple cases; problem-solve in real time.
• Digital fluency with CRM platforms and technology-enabled patient support tools (including AI).

• 401(k) with company match; comprehensive medical/dental/vision; company-paid Life/AD&D; company-paid short/long-term disability; EAP; HSA/FSA; paid parental leave; performance-based incentives; plus other listed supplemental plans (pet/legal; accident/critical illness/hospital indemnity).